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. 2019 Nov 18;13:1218. doi: 10.3389/fnins.2019.01218

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Copyright © 2019 Zortea, Ramalho, Alves, Alves, Braulio, Torres, Fregni and Caumo.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Areas of the brain that induction the descending pain inhibitory system composed by PAG-RVM-spinal cord pathway. TH, Thalamus; HT, hypothalamus; AMY, amygdala; NCF, nucleus cuneiforms; PAG, periaqueductal gray matter; DLPT, dorsolateral pontine tegmentum; RVM, rostral ventromedial medulla. (1) Cortical regions as cingulate and insula cortex as also the subcortical regions how the thalamus, hypothalamus, and amygdala project signals for the PAG, gray substance located in the midbrain, that receives stimulus and send inhibitory impulses across the medial and lateral tracts of the CNS. (2) Medial tract: inhibitory and facilitatory influence of the neurotransmitter serotonin in the pain activeness. (3) Lateral tract: dominant activity of neurotransmitter noradrenaline. (4) Fired inhibitory stimulus go down throughout dorsal horn of the spinal cord segment. The painful stimuli are sent to the second order neurons. Endorphins, noradrenaline, and serotonin, inhibitory neurotransmitters, are released activation of the inhibitory interneurons.